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* 1. Please provide your contact information.

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* 2. Birth date  MM/DD/YYYY:

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* 4. My employer has a matching gift program.

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* 5. Are you a Thrivent Choice participant?

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* 6. Would you like to receive Samaritan's monthly eNewsletter, as well as other information and invitations via email?

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* 7. If you answered 'yes,' please provide your email address:

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* 8. Which events/campaigns/workshops are you interested in? (Check all that apply)

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* 9. How did you come to be a donor at Samaritan Counseling Center? (Check all that apply)

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* 10. How often would you like to be updated on our activity?:

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* 11. Please indicate if you agree or disagree:

  Agree Disagree
I believe my donation to Samaritan is important.
I believe the impact of my donation is clear and measurable.
I believe my donation to Samaritan is managed properly.
I believe mental health should be a top priority in our community.

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* 12. What are the guiding principles you use to make your philanthropic decisions?

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* 13. To what extent does our mission (vision, work) reflect your personal beliefs?

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* 14. What do you expect from the charitable organizations in which you are involved?

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* 15. To what extent are we meeting those expectations?

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* 16. Of the charities to which you donate, which ones do the best job sharing the significance and impact of your gifts? How so?

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* 17. Check all that apply:

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* 18. What advice would you like to give us?

0 of 18 answered
 

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